Provider Demographics
NPI:1912919481
Name:CHILDRENS HOSPITAL OF THE KINGS DAUGHTERS INC
Entity type:Organization
Organization Name:CHILDRENS HOSPITAL OF THE KINGS DAUGHTERS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR VP/CFO
Authorized Official - Prefix:
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:J
Authorized Official - Last Name:ABSHIRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-668-8565
Mailing Address - Street 1:601 CHILDRENS LN
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23507-1910
Mailing Address - Country:US
Mailing Address - Phone:757-668-7017
Mailing Address - Fax:757-668-8646
Practice Address - Street 1:601 CHILDRENS LN
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23507-1910
Practice Address - Country:US
Practice Address - Phone:757-668-7017
Practice Address - Fax:757-668-8929
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-13
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X, 261QE0700X, 261QU0200X, 291U00000X
VAH1843282N00000X, 282NC2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes282NC2000XHospitalsGeneral Acute Care HospitalChildren
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) TreatmentGroup - Multi-Specialty
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No282N00000XHospitalsGeneral Acute Care Hospital
No291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA000082OtherANTHEM BC BS
VA116838OtherANTHEM TRANSPORT
NC4903301Medicaid
VA004930177Medicaid
VA236297OtherMDIPA
NC001AYOtherSTATE OF NC TEACHERS & ST
VA004900961Medicaid
DE0000620505Medicaid
VA169288OtherANTHEM REFERENCE LAB
VA236297OtherALLIANCE
VA009013857Medicaid
VA0096618OtherAETNA
WV0175123000Medicaid
VA184601OtherANTHEM OYSTER POINT
VA236297OtherOPTIMUM CHOICE
VA4900961OtherVIRGINIA PREMIER
VA236297OtherOPTIMUM CHOICE
VA=========OtherOPTIMA/SENTARA
VA=========OtherTRICARE (HEALTHNET)
VA169288OtherANTHEM REFERENCE LAB
VA184601OtherANTHEM OYSTER POINT